Abstracts

RATIONALE: Women with epilepsy are more likely to have reproductive dysfunction, including an increased number of anovulatory menstrual cycles and altered levels of ovarian steroids. (Morrell, M [italic]Neurology[/italic] 53supp1:S42-48, 1999) The mechanism for this reproductive dysfunction is postulated to be related in part to disturbances in the hypothalamic-pituitary axis. Disruption in the hypothalamic-pituitary-ovarian axis function could disturb the transition across reproductive stages, including at puberty and at menopause. In fact, there has been concern in the literature that individuals with epilepsy may have delayed puberty. We assessed age of menarche in outpatient women with epilepsy to determine whether the age of menarche was different from nonepileptic women.
METHODS: 84 women with epilepsy, age 18-40, were enrolled in a study investigating the effects of anti-epileptic medications on reproductive function. They were asked to self-report their age of menarche in an extensive reproductive history questionnaire. 31/84 were diagnosed with primary generalized epilepsy (PGE); 53/84 with localization-related epilepsy (LRE).
RESULTS: The mean age of menarche was 12.6 years of age (SD 1.5) for women with PGE, 12.5 years of age (SD 1.5) for women with LRE. This is no different from the median age of menarche in the U.S., which is 12.8 years (Speroff et al, [italic]Clinical Gynecologic Endocrinology and Infertility[/italic], Baltimore, 1994, pg 369).
CONCLUSIONS: Age of menarche appears to be within the normal range for women with epilepsy, regardless of syndrome. This suggests that any hypothalamic-pituitary-gonadal axis disturbance is not sufficient to affect maturation of the reproductive system. Further evaluation of puberty as a function of AED therapy and seizure frequency will refine this observation.
Support: This study has been sponsored by Glaxo Wellcome, Inc.